A patient with kidney failure is prescribed a medication that is primarily excreted through the kidneys. Which of the following statements is most accurate regarding the pharmacokinetics of this medication?
Hepatic metabolism will fully compensate for the decreased renal excretion
Dose adjustment may be necessary to prevent drug accumulation
The medication's half-life will likely be shorter due to decreased renal function
The risk of drug toxicity is decreased due to impaired excretion
The Correct Answer is B
A. Hepatic metabolism will fully compensate for the decreased renal excretion: This is inaccurate. While the liver may play a role in metabolizing some drugs, it cannot fully compensate for reduced renal clearance of medications that are primarily excreted by the kidneys.
B. Dose adjustment may be necessary to prevent drug accumulation: In patients with kidney failure, reduced renal clearance slows the elimination of renally-excreted drugs. Without dose adjustment, drug levels can build up, increasing the risk of toxicity. Dosing must be tailored to the patient’s renal function, often guided by creatinine clearance or GFR.
C. The medication's half-life will likely be shorter due to decreased renal function: The opposite is true. Impaired renal function slows drug excretion, prolonging the drug’s half-life, which means the drug stays in the system longer and can accumulate to toxic levels if not adjusted.
D. The risk of drug toxicity is decreased due to impaired excretion: Impaired excretion increases, not decreases, the risk of toxicity. Renally-excreted drugs that are not properly cleared can accumulate and reach dangerous concentrations in the bloodstream.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Advise the patient to continue using the nasal decongestant but reduce the frequency to once daily: Continued use, even at a reduced frequency, may not resolve the underlying issue. Prolonged use of topical nasal decongestants can lead to rebound congestion (rhinitis medicamentosa), which won't improve without discontinuation.
B. Suggest increasing the dosage of the current nasal decongestant to manage congestion: Increasing the dosage worsens rebound congestion and the dependence cycle. Higher doses can also raise the risk of systemic side effects such as elevated blood pressure or tachycardia.
C. Educate the patient on discontinuing the nasal decongestant and recommend a saline nasal spray for symptom relief: This is the most appropriate intervention. Rebound congestion is best managed by stopping the decongestant. Saline sprays help moisturize nasal passages and reduce symptoms safely during withdrawal.
D. Prescribe a stronger nasal decongestant to alleviate symptoms more effectively: A stronger formulation would likely exacerbate the problem. The key to managing rhinitis medicamentosa is breaking the cycle of decongestant overuse, not intensifying it.
Correct Answer is A
Explanation
A. "I should report a persistent cough to my provider.": A dry, persistent cough is a common side effect of ACE inhibitors like Lisinopril. Reporting this symptom is important, as the provider may consider switching to another class of antihypertensives if it becomes bothersome.
B. "I should take this medication as needed.": Lisinopril must be taken consistently every day to manage blood pressure effectively. Taking it only when symptoms are present is inappropriate and can lead to poor control and serious complications.
C. "I should expect to have facial swelling when taking this medication.": Facial swelling (angioedema) is a serious and potentially life-threatening adverse effect, not something to expect or tolerate. If it occurs, the medication should be stopped and medical help sought immediately.
D. "I should increase my intake of potassium-rich foods.": Lisinopril can increase serum potassium levels, leading to hyperkalemia. Clients should be advised to avoid excessive potassium intake and may need periodic lab monitoring.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.